Hysterectomy Risks

By Dr Ananya Mandal, MD

As with any other major surgical procedures, hysterectomy is associated with certain risks and side effects.

Mortality within 40 days of surgery is estimated to range somewhere between 1 and 6 for each thousand hysterectomies performed due to benign causes. The risk is significantly increased among women who have cancer, fibroids or are pregnant.

Women need to stay in hospital after a hysterectomy for up to five days if they have had an abdominal procedure and up to three days when a laparoscopically assisted vaginal procedure is used. It can take up to eight weeks for a woman to fully recover from the procedure.

Some of the risks and complications associated with hysterectomy include:

Internal bleeding

In all major surgeries, there is a risk of hemorrhage (heavy bleeding) after a hysterectomy. Blood transfusions are therefore available to treat patients who experience such blood loss after the procedure.

Unintended oophorectomy leading to premature ovarian failure

In many cases of hysterectomy, one or both of the ovaries may be removed even though the original intention was to spare them. This can bring forward the age at which a woman’s goes through the menopause, which may occur around 3 years earlier than it would have done. Removal of the ovaries causes a sharp fall in the estrogen level, which removes the protective effect of estrogen against cardiovascular and skeletal disease. Hysterectomy has been associated with increased rates of heart disease and osteoporosis.

Benign ovarian cysts

A significant number of women who undergo hysterectomy develop benign ovarian cysts afterwards.

Ureter damage

The tube through which urine passes to leave the body can get damaged during a hysterectomy and this occurs in around 1% of cases. However, this damage is usually noticed and repaired during the hysterectomy. Other abdominal organs such as the bladder or bowel are also at risk of damage, which can lead to infection or incontinence, for example. In some cases, the damage may be repaired during the hysterectomy but in cases where this is not possible, the patient may need to use a catheter or colostomy bag until further surgery can be arranged.

Effects on sex life

Women often report less pelvic pain and an improved sex life after a hysterectomy is performed for benign indications, although some say they see a worsening of problems related to their sex life. A hysterectomy that is performed due to the presence of malignancy is often significantly more radical and associated with much more severe side effects that have a negative impact on sex life.

Infection

As with all surgeries, hysterectomy is associated with the risk of infection, such as a urinary tract infection or infection at the site of surgery. Most infections are not severe and can easily be treated with a course of antibiotics.

Thrombosis (blood clot)

The risk of developing thrombosis is increased in those who have had an operation and been immobile for periods. If thrombosis occurs, patients are encouraged to move around and blood thinning medication may also be administered, to reduce the risk of clots forming.

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